Nihon Kikan Shokudoka Gakkai Kaiho
Online ISSN : 1880-6848
Print ISSN : 0029-0645
ISSN-L : 0029-0645
Reconstructive Surgery for Recurrent Laryngeal Nerve Paralysis
Fumihiko SatoHitoshi SaitoHiroshi TakenakaKazuo UedeTakehisa SaitoSachio YoshidaToshihito TsubokawaTaisuke KurokawaNizo TakanamiNobuo MatsumotoOsamu MizukoshiYasuo Hisa
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1986 Volume 37 Issue 2 Pages 126-132

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Abstract
As functional reconstructive surgeries for recurrent laryngeal nerve paralysis, there are static reconstruction such as intracordal silicone injection or Woodmann's operation, and dynamic reconstruction such as free nerve grafting and pedicle nerve muscle grafting.
This paper is mainly concerned with the present situation and indication of each surgical procedure for recurrent laryngeal nerve paralysis. In order to clear the indication of the surgery, recurrent laryngeal nerve paralysis was classified pathophysiologically into four degrees: I. Condition of neurapraxia or its combination with axonotmesis, in which vocal cord movement might be recovered. II. Condition of axonotmesis or its combination with few neurotmesis, in which atrophy of the vocal cord exists and the movement could not be recovered. III. Condition of neurotmesis, in which atrophy and high level of the vocal cord exist. IV. Condition of severe neurotmesis, in which the vocal cord atrophies progressively.
The mediofixation of the vocal cord for unilateral paralysis is indicated to vocal cord atrophy (II grade) and mediofixation of the vocal process by adduction of the arytenoid cartilage is indicated to the high level vocal cord. Dynamic reconstruction is needed for unilateral nerve defect at thyroidectomy. Surgical procedure for bilateral paralysis is selected depending on the degree of dyspnea.
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© The Japan Broncho-esophagological Society
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